An estimated sixty-five
percent of Americans have bad breath. Over forty-million Americans have
“chronic halitosis,” which ispersistent
bad breath. Ninety percent of all halitosis is of oral, not systemic, origin.
Americans spend more than $1 billion
a year on over the counter halitosis products, many of which are ineffective
because they only mask the problem.
What causes bad breath?
Bad breath is caused by a variety of
factors. In most cases, it is caused by food remaining in the mouth – on the
teeth, tongue, gums, and other structures, collecting bacteria. Dead and dying
bacterial cells release a sulfur compound that gives your breath an unpleasant
odor. Certain foods, such as garlic and onions, contribute to breath odor. Once
the food is absorbed into the bloodstream, it is transferred to the lungs,
where it is exhaled. Brushing, flossing and mouthwash only mask the odor. Dieters
sometimes develop unpleasant breath from fasting.
Periodontal (gum) disease often
causes persistent bad breath or a bad taste in the mouth, and persistent bad
breath may mean a sign that you have gum disease.
Gum disease is caused by plaque – the
sticky, often colorless, film of bacteria that constantly forms on teeth. Dry
mouth or xerostomia may also cause bad breath due to decreased salivary flow.
Saliva cleans your mouth and removes particles that may cause odor. Tobacco
products cause bad breath, stain teeth, reduce your ability to taste foods and
irritate your gum tissues. Bad breath may also be a sign that you have a
serious health problem, such as a respiratory tract infection, chronic
sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal
disturbance, liver or kidney ailment.
Here are characteristic bad breath
odors associated with some of these illnesses:
- Diabetes
– acetone, fruity
- Liver
failure – sweetish, musty
- Acute
rheumatic fever – acid, sweet
- Lung
abscess – foul, putrefactive
- Blood
dyscrasias – resembling decomposed blood
- Liver
cirrhosis – resembling decayed blood
- Uremia
– ammonia or urine
- Hand-Schuller-Christian
disease – fetid breath and unpleasant taste
- Scurvy
– foul breath from stomach inflammation
- Wegner`s
granulomatosis – Necrotic, putrefactive
- Kidney
failure – ammonia or urine
- Diphtheria,
dysentery, measles, pneumonia, scarlet fever, tuberculosis – extremely
foul, fetid odor
- Syphilis
– fetid
Bad breath may also be caused by
medications you are taking, including central nervous system agents,
anti-Parkinson drugs, antihistamines/decongestants, anti-psychotics,
anti-cholinergics, narcotics, anti-hypertensives, and anti-depressants.
Caring for bad breath
Daily brushing and flossing, and
regular professional cleanings, will normally take care of unpleasant breath.
And don’t forget your often overlooked tongue as a culprit for bad breath.
Bacterial plaque and food debris also can accumulate on the back of the tongue.
The tongue’s surface is extremely rough and bacteria can accumulate easily in
the cracks and crevices.
Controlling periodontal disease and
maintaining good oral health helps to reduce bad breath. If you have
constant bad breath, make a list of the foods you eat and any medications you
take. Some medications may contribute to bad breath.
Improperly cleaned dentures can also
harbor odor-causing bacteria and food particles. If you wear removable
dentures, take them out at night and clean them thoroughly before replacing
them.
If your dentist determines that your
mouth is healthy and that the odor is not oral in nature, you may be referred
to your family physician or to a specialist to determine the cause of the odor
and possible treatment. If the odor is due to gum disease, your dentist can
either treat the disease or refer you to a periodontist, a specialist in
treating gum tissues. Gum disease can cause gum tissues to pull away from the
teeth and form pockets. When these pockets are deep, only a professional
periodontal cleaning can remove the bacteria and plaque that accumulate.
Mouthwashes are generally ineffective
on bad breath. If your bad breath persists even after good oral hygiene, there
are special products your dentist may prescribe, including Zytex, which is a
combination of zinc chloride, thymol and eucalyptus oil that neutralizes the
sulfur compounds and kills the bacteria that causes them. In addition, a
special antimicrobial mouth rinse may be prescribed. An example is chlorhexidine,
but be careful not to use it for more than a few months as it can stain your
teeth. Some antiseptic mouth rinses have been accepted by the American Dental
Association for their breath freshening properties and therapeutic benefits in
reducing plaque and gingivitis. Instead of simply masking breath odor, these
products have been demonstrated to kill the germs that cause bad breath. Ask
your dentist about trying some of these products.